Watch out for food allergies in infants!

Last updated date: 06-Sep-2021

Acibadem International Hospital

7 mins read

Advices to guide parents on food allergy, which has gradually become prevalent…

What you should know about food allergies in infants

All parents act meticulously when it comes to health of their child. They show the necessary care every day, starting at birth, for a healthy diet to protect their children against diseases. But, the child’s immune system may react to certain foods, despite a perfectly healthy diet.


Symptoms of food allergy

Food allergy may manifest symptoms including but not limited to red skin rash, wheezing and cough, vomiting, constipation and blue discoloration of lips (cyanosis) in food allergy, which is an inevitable problem of the modern age. Food allergy may sometimes show symptoms similar to that of common cold and flu, while it may also cause sudden death. Risk of food allergy within the first 5 to 7 years is 20 percent higher for infants with at least one parent or sibling with allergic history such as allergic rhinitis, asthma, food allergy or eczema.


Additives cause food allergy

While certain ingredients in foods, including cow’s milk, egg yolk, hazelnut, peanuts and walnuts, can cause allergies; sweeteners, coloring agents, stabilizers and preservatives added to processed food also pave the way for allergic reactions. There are nearly 3 thousand additives worldwide. It is believed that the increasing prevalence of food allergies in children of industrializing populations is secondary to allergic reactions against these additives. Hormones and micro-organisms in food may cause adverse reactions.


Complaints are more severe in egg allergy

Cow’s milk allergy is the most common type of this condition in infants. However, this allergy usually disappears spontaneously by 2 to 3 years of age. Egg allergy is more common especially in infancy and early childhood. Reactions may alleviate over years and completely disappears in adulthood. Eczema or itching, skin and eye lesions are more common in egg allergy when compared to other food allergies. Being manifested by generalized redness, wheezing, vomiting and diarrhea, the egg allergy is deemed the most prominent cause of eczema in infants. Moreover, foods that most commonly cause allergy include but are not limited to soy beans, peanut, shellfish and sea food, wheat and other grains; tahini, sesame, tomato, cocoa, strawberries, banana, orange, oat meal, barley and rye. Strawberry and tomato cause allergy-like reactions, as they contain certain chemical, called histamine.


Symptoms may develop 72 hours after the ingestion

Allergic symptoms may develop within first minutes or 1 to 2 hours after the body exposes to the allergen. The body may react 72 hours later, albeit rare. Food allergies may manifest skin rash, anal hyperemia, blue discoloration of lips (cyanosis) and wheezing or asthma as well as gastrointestinal symptoms. Gastrointestinal system may respond to the offending food with vomiting, diarrhea, blood in stool or constipation. Acid reflux may be seen in infants. Food allergies can play a role in infants who usually suffer from gas and babies with insufficient weight gain and growth and developmental retardation. On the other hand, very severe and sudden-onset reactions cause respiratory problems called anaphylaxis, which can be life-threatening.


The mother can pass the allergy through breast feeding

Food allergy usually begins after breast feeding for 6 months, once supplemental food is started. But, the allergy may be passed to the baby through breast feeding, if the mother’s diet is rich in allergic foods or additives. Newborn babies who are only fed breast milk are more likely to develop blood or mucous in stool, severe colic, symptoms of reflux, recurrent diaper rash and decreased rate of weight gain. If the infant is allergic to cow’s milk, the mother should avoid certain foods, such as butter, butter-flavored oil, types of cheese, yogurt, partially hydrolyzed food, lactose, pudding, halva, food flavors, teas with lactose that boost milk production, cooking cream and custard, as long as she breastfeeds. Sufficient calcium, Vitamin D and iron supplements are required for mothers with strict diets.


Diagnosis is made with food allergy test

Food allergy may not be diagnosed with laboratory tests within the first 6 months, due to underdeveloped immune system. Therefore, clinical diagnosis plays a more important within the first 6 months. Conclusive clues are obtained for older babies through laboratory tests such as skin prick test, RAST test for specific IgE and provocation test. There are two types of food allergies: IgE mediated and non-IgE mediated. The offending food can be determined through blood work in IgE mediated food allergy. Non-IgE mediated food allergies are classified as follows: food protein-induced enterocolitis, proctocolitis and food-protein induced enteropathies. Tests do not have any diagnostic value when this type is concerned. Diagnosis is based on clinical particulars and history. Diagnosis is made by observing symptoms after suspected food is removed from the diet and adding it again after symptoms alleviate following a certain time.


Mother’s duties in food allergies

Supplemental food should be chosen very carefully in order to determine if the infant is allergic to a certain food. It is important to start a new food in small amounts and to observe reactions. Each food should be tried alone for minimum 3 days; the amount should be increased by one spoon each day; the new supplemental food should be touched to the infant’s cheek; vegetable soup and grains should initially be fed in small servings when supplemental food is added to the diet. Moreover, egg yolk should not be started before 1 year of age; cheese, yogurt and eggs require being very careful and the amount should be increased gradually. Loading dose is given under supervision of a doctor and the offending food can be added to the diet for highly allergic infants. The offending food can be fed in small amounts by notifying the physician to build tolerance for babies with mild allergy. When trying a food for the first time, allergic effect of dairy products can be dampened by baking or cooking.


Meat should be added at 6 months

Food allergy for chicken and beef may develop due to cross antigenic features before 1 year in children who are allergic to milk and egg. Babies should be started with lamb at 6 and 7 months of age. Prevalence of pollen allergy increases for children with fruit and vegetable allergy. Parsley allergy is more likely in people with grass allergy. Allergic people can eat fruits and vegetables after they are cooked, since their protein is not resistant to heat. Amino-acid based formulas are recommended for severe cases due to common cross reaction between soy protein, goat milk and cow’s milk. Hydrolyzed formulas can be preferred for milder cases, but allergic reactions may develop against these formulas. Breastfeeding should be maintained; formulas without cow’s milk protein should be fed when breast milk is insufficient.


Ways to prevent food allergy

Babies with family history of food allergy should absolutely be fed only breast milk in the first 6 months; solid foods should not be started earlier. Mothers with risk factors should not eat excessive amount of nuts and shellfish; children should not eat fish before 2 to 3 years. Special formulas without cow’s milk protein should be preferred for babies with food allergy. Cow’s milk and foods that contain cow’s milk should be removed from the infant’s diet; they should also be removed from the mother’s diet, if the baby is only breastfed. Food allergy should be investigated in infants with excessive gas, continuous severe facial redness and exfoliation and dermatitis on scalp. Also, a high index of suspicion is required for food allergy, if the infant cries too frequently or has persistent nasal congestion with no clear cause and in case of runny nose, itching and watering of eyes after ingestion of certain foods.


Probiotic agents provide great benefits in treatment of food allergy

Although the effects of probiotic agents (living organisms that regulate microbial flora in intestines) on allergic problems are not clearly known, evidences suggest that it helps development of hereditary immune system by affecting the fecal mucosa. Animal studies reveal out that a certain amount of bacteria can reduce the immunity sensitivity, which causes the allergies. A Finland study concludes that probiotic cultures are effective in preventing early atopic diseases in children with high risk. In conclusion, probiotic agents and natural immune system elements are regarded to have an important role in preventing atopic diseases in intestinal microflora. 


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